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Fortney CA, Garcia D, Gerhardt CA, Baughcum AE, Slaughter JL, Rodriguez EM. Pilot Testing Transcreated Spanish-Language Study Materials for Symptom Research With Infants and Parents in the Neonatal Intensive Care Unit. Adv Neonatal Care 2024; 24:243-252. [PMID: 38729653 PMCID: PMC11141341 DOI: 10.1097/anc.0000000000001166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2024]
Abstract
BACKGROUND Rising admission rates of Hispanic/Latinx families to the neonatal intensive care unit (NICU) have increased the number of non-English-speaking individuals who may wish to participate in research studies. However, a lack of appropriately translated research study materials may limit the opportunity for these families to be involved in research that could impact the care that infants and families receive in the NICU. PURPOSE The primary purpose was to pilot test study materials that were transcreated from English to Spanish with the assistance of a bilingual community advisory board with Spanish-speaking parents of NICU infants. METHODS A total of 19 Spanish-speaking parents (15 mothers and 4 fathers) who were representative of the population of interest completed paper-and-pencil surveys, along with a cognitive interview. Preliminary data related to decision-making and goals of care, infant symptoms, and their experiences in the NICU were also collected. RESULTS The internal reliability of the transcreated study instruments ranged from good to excellent (α= 0.82-0.99). Participants reported that study materials were not offensive and did not make them feel uncomfortable; however, they found some words/phrases to be confusing. Parents had the opportunity to provide suggested wording changes. IMPLICATIONS FOR PRACTICE AND RESEARCH Language barriers and a lack of cultural responsiveness can affect the care that infants and their families receive. More accurate and culturally appropriate transcreation of study materials can remove barriers to research participation and facilitate better communication with non-English-speaking families, which may lead to the development of better-informed evidence-based interventions and clinical practices in the NICU.
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Affiliation(s)
- Christine A Fortney
- Martha S. Pitzer Center for Women, Children & Youth (Dr Fortney), The Ohio State University College of Nursing, Columbus, Ohio; Center for Biobehavioral Health (Dr Fortney, Ms Garcia, and Dr Gerhardt), Center for Perinatal Research (Dr Slaughter), Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, Ohio; Department of Pediatrics (Dr Gerhardt, Dr Baughcum, and Dr Slaughter), The Ohio State University College of Medicine, Columbus, Ohio; Department of Psychology (Dr Gerhardt), The Ohio State University, Columbus, Ohio; Departments of Psychology and Neuropsychology (Dr Baughcum), Division of Neonatology (Dr Slaughter), Nationwide Children's Hospital, Columbus, Ohio; and Department of Educational Psychology (Dr Rodriguez), College of Education, University of Texas at Austin, Austin, Texas
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Dube AR, Ortega P, Hardin DM, Hardin K, Martinez F, Shah M, Naimi BR, Esteban-González AI, Dickmeyer J, Ruggiero D, Abraham V, Diamond LC, Cowden JD. Improving Assessment and Learning Environments for Graduate Medical Trainees to Advance Healthcare Language Equity. J Gen Intern Med 2024; 39:696-705. [PMID: 38093027 PMCID: PMC10973305 DOI: 10.1007/s11606-023-08527-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 11/02/2023] [Indexed: 03/28/2024]
Abstract
Language-appropriate care is critical for equitable, high-quality health care, but educational standards to assure graduate medical trainees are prepared to give such care are lacking. Detailed guidance for graduate medical education is provided by the Accreditation Council for Graduate Medical Education through the following: (1) an assessment framework for competencies, subcompetencies, and milestones for trainees and (2) the Clinical Learning Environment Review (CLER) Pathways for assessment of trainees' learning environments. These tools do not include a robust framework to evaluate trainees' abilities to offer language-appropriate care. They also do not address the learning environment's potential to support such care. A multidisciplinary group of linguistic, medical, and educational experts drafted a new subcompetency with milestones and an expanded CLER Pathway to highlight the importance of equitable care for patients who prefer languages other than English. These resources offer residency and fellowship programs tools to guide assessment, curriculum development, and learning-environment improvements related to language-appropriate care. Recognizing that programs have unique needs and resources, we propose a range of initial actions to address language equity. A focus on language diversity in the learning environment can have a broad and lasting impact on care quality, patient safety, and health equity.
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Affiliation(s)
- Amanda R Dube
- Rady Children's Hospital-San Diego, San Diego, CA, USA
| | - Pilar Ortega
- Accreditation Council for Graduate Medical Education, Chicago, IL, USA
- University of Illinois College of Medicine, Chicago, IL, USA
| | | | | | - Francisco Martinez
- Department of Pediatrics, Children's Mercy Kansas City, Kansas City, MO, USA
| | - Madhura Shah
- Boston University School of Medicine, Boston, MA, USA
| | | | | | - Jodi Dickmeyer
- Department of Pediatrics, Children's Mercy Kansas City, Kansas City, MO, USA
- University of Missouri-Kansas City School of Medicine, Kansas City, MO, USA
| | | | - Veronica Abraham
- F Edward Hébert School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Lisa C Diamond
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - John D Cowden
- Department of Pediatrics, Children's Mercy Kansas City, Kansas City, MO, USA.
- University of Missouri-Kansas City School of Medicine, Kansas City, MO, USA.
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Nissen V, Meuter RFI. The impact of bilinguality and language context on the understanding of epistemic adverbs in health communication: the case of English and Russian. Front Psychol 2023; 14:1179341. [PMID: 37397294 PMCID: PMC10313332 DOI: 10.3389/fpsyg.2023.1179341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Accepted: 05/25/2023] [Indexed: 07/04/2023] Open
Abstract
Aim To explore how English epistemic adverbs, as used in health communication, are understood by speakers depending on their first language (L1) and language context. Methods We used an online dissimilarity rating task with paired doctors' opinions which differed only with respect to the embedded epistemic adverbs (e.g., This treatment definitely has side effects vs. This treatment possibly has side effects). In order to evaluate the possible effect of one's L1, we compared the ratings of English-speaking monolinguals and Russian-English bilinguals in Australia (Study 1). To evaluate the impact of language context, we compared the ratings of Russian-English bilinguals in Australia and Russia (Study 2). The data were interpreted using classical multidimensional scaling (C-MDS) analysis, complemented by cultural consensus analysis and hierarchical cluster analysis. Results The C-MDS analyses returned statistically acceptable results. Intragroup consensus was evident for all speaker groups. They all clustered the high confidence adverbs (clearly, definitely, and obviously) and the hearsay adverbs (presumably and supposedly) similarly. Effects of L1 were seen: for example, unlike the monolinguals, the Russian bilinguals did not include evidently with the high confidence adverbs (Study 1). An effect of context was also evident: Russian-English bilinguals in Australia most resembled the monolinguals in their understanding of epistemic adverbs. The way Russian-based bilinguals clustered epistemic adverbs reflected a less nuanced understanding (Study 2). Conclusion The subtle differences in how adverbs of likelihood and doubt are understood in health communication suggest extra care is needed when conveying risk and uncertainty to patients from diverse linguistic and/or cultural backgrounds to ensure mutual understanding and mitigate against miscommunication. The impact of L1 and language context on one's understanding highlights the need to explore more widely how epistemic adverbs are understood by diverse populations and, in doing so, improve healthcare communication practices.
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Gotting EK, Ferm U, Wigert H. Communication between parents and neonatal healthcare professionals using pictorial support when language barriers exist – parents’ experiences. Int J Qual Stud Health Well-being 2022; 17:2122151. [PMID: 36071676 PMCID: PMC9467535 DOI: 10.1080/17482631.2022.2122151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
Purpose Method Results Conclusion
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Affiliation(s)
- Eva-Karin Gotting
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Division of Paediatrics, ANS Hospital, Angered, Sweden
| | - Ulrika Ferm
- DART Centre for Augmentative and Alternative Communication and Assistive Technology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Helena Wigert
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Division of Neonatology, Sahlgrenska University Hospital, Gothenburg, Sweden
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More than words: Parent, Patient and Public Involvement perspectives on language used by clinical researchers in neonatal care. Early Hum Dev 2022; 171:105611. [PMID: 35785689 DOI: 10.1016/j.earlhumdev.2022.105611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 06/12/2022] [Indexed: 11/21/2022]
Abstract
In this qualitative study exploring parent views of information about research studies, we found they accepted uncertainty as justification, and that three key aspects of language - words, tone, and pace - influence parents' decision about their baby's inclusion. We recommend parents are routinely involved in developing information materials.
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Nyande FK, Ricks E, Williams M, Jardien-Baboo S. Socio-cultural barriers to the delivery and utilisation of child healthcare services in rural Ghana: a qualitative study. BMC Health Serv Res 2022; 22:289. [PMID: 35241071 PMCID: PMC8892726 DOI: 10.1186/s12913-022-07660-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Accepted: 02/18/2022] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Over half of global deaths among children under five years of age occur in sub-Saharan Africa. Prompt and consistent access to and utilisation of child healthcare services improves child health outcomes. However, socio-cultural barriers impede the utilisation of child healthcare services among rural dwellers in Ghana. There is a paucity of studies that explore the experiences of nurses and caregivers regarding the socio-cultural barriers to the delivery and utilisation of child healthcare services in rural areas in Ghana such as the Nkwanta South Municipality. PURPOSE The purpose of this study was to explore the experiences of nurses and caregivers regarding the socio-cultural barriers that impede the delivery and utilisation of child healthcare services by caregivers for their children in the Nkwanta South Municipality, Ghana. METHODS Data were collected through semi-structured interviews conducted with a purposive sample of ten nurses and nine caregivers of children under five years of age who utilised the available child healthcare services in a rural setting. The consent of all participants was sought and given before interviews were conducted. Data analysis entailed coding and the generation of themes the codes. RESULTS The exploration of experiences of nurses and caregivers of children under-five years of age revealed that certain socio-cultural beliefs and practices, language barriers and reliance of caregivers on self-medication were the main socio-cultural barriers that impeded the delivery and utilisation of child healthcare services in the Nkwanta South Municipality. CONCLUSION Nurses and caregivers experienced several socio-cultural barriers which either delayed care seeking by caregivers for their sick children or interfered with the smooth and prompt delivery of needed child healthcare services by nurses. Some of the barriers negatively affected the interaction between nurses and caregivers with the tendency to affect subsequent child healthcare service utilisation. It is recommended that healthcare managers and nurses should foster close collaboration with caregivers and community leaders to address these socio-cultural barriers and facilitate prompt and consistent utilisation of child healthcare service in rural areas.
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Affiliation(s)
- Felix Kwasi Nyande
- Department of Nursing, School of Nursing and Midwifery, University of Health and Allied Sciences, Ho, Ghana.
- Department of Nursing Science, Faculty of Health Sciences, Nelson Mandela University, Port Elizabeth, South Africa.
| | - Esmeralda Ricks
- Department of Nursing Science, Faculty of Health Sciences, Nelson Mandela University, Port Elizabeth, South Africa
| | - Margaret Williams
- Department of Nursing Science, Faculty of Health Sciences, Nelson Mandela University, Port Elizabeth, South Africa
| | - Sihaam Jardien-Baboo
- Department of Nursing Science, Faculty of Health Sciences, Nelson Mandela University, Port Elizabeth, South Africa
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Labrie NHM, van Veenendaal NR, Ludolph RA, Ket JCF, van der Schoor SRD, van Kempen AAMW. Effects of parent-provider communication during infant hospitalization in the NICU on parents: A systematic review with meta-synthesis and narrative synthesis. PATIENT EDUCATION AND COUNSELING 2021; 104:1526-1552. [PMID: 33994019 DOI: 10.1016/j.pec.2021.04.023] [Citation(s) in RCA: 48] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 04/21/2021] [Accepted: 04/22/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVE To synthesize and analyse the literature on the effects of parent-provider communication during infant hospitalization in the neonatal (intensive) care unit (NICU) on parent-related outcomes. METHODS Systematic review with meta-synthesis and narrative synthesis. Databases (PubMed, PsycINFO, Cochrane Library, CINAHL, Web of Science, Scopus) were searched in October/November 2019. Studies reporting, observing, or measuring parent-related effects of parent-provider communication in the NICU were included. Study quality was assessed using the Quality Assessment Tool for Studies with Diverse Designs. Qualitative studies were meta-synthesized using deductive and inductive thematic analysis. Quantitative studies were analysed using narrative synthesis. RESULTS 5586 records were identified; 77 were included, reporting on N = 6960 parents, N = 693 providers, and N = 300 NICUs. Analyses revealed five main (positive and negative) effects of parent-provider interaction on parents' (1) coping, (2) knowledge, (3) participation, (4) parenting, and (5) satisfaction. Communication interventions appeared impactful, particularly in reducing parental stress and anxiety. Findings confirm and refine the NICU Communication Framework. CONCLUSIONS Parent-provider communication is a crucial determinant for parental well-being and satisfaction with care, during and following infant hospitalization in the NICU. R. Practice Implications: Providers should particularly consider the impact on parents of their day-to-day interaction - the most occurring form of communication of all.
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Affiliation(s)
- Nanon H M Labrie
- Athena Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands; Department of Pediatrics and Neonatology, OLVG, Amsterdam, The Netherlands.
| | - Nicole R van Veenendaal
- Department of Pediatrics and Neonatology, OLVG, Amsterdam, The Netherlands; Amsterdam UMC, University of Amsterdam, Vrije Universiteit, Emma Children's Hospital, Amsterdam, The Netherlands
| | | | - Johannes C F Ket
- Medical Library, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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Patriksson K, Wigert H, Berg M, Nilsson S. Health care professional's communication through an interpreter where language barriers exist in neonatal care: a national study. BMC Health Serv Res 2019; 19:586. [PMID: 31426785 PMCID: PMC6701045 DOI: 10.1186/s12913-019-4428-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Accepted: 08/13/2019] [Indexed: 11/14/2022] Open
Abstract
Background A number of parents in neonatal care are foreign-born and do not speak the local language, which makes communication between healthcare professionals and parents more difficult. Interpreters can be used when language barriers exist - parent interactions, medical communication and communication about the care of the child. The aim in this study was to examine healthcare professionals’ use of interpreters and awareness of local guidelines for interpreted communication in neonatal care. Method A survey was distributed to all 2109 employees at all 38 neonatal units in Sweden, thus to all physicians, registered nurses and nurse assistants in active service. Data were analysed with descriptive statistics and dichotomized so the professionals were compared in groups of two using the Mantel-Haenszel Chi Square test and Fisher’s Non Parametric Permutation test. Results The survey was answered by 41% (n = 858) representing all neonatal units. The study showed a difference between the professional groups in awareness of guidelines, availability of interpreters, and individual resources to communicate through an interpreter. Nurse assistants significantly lesser than registered nurses (p < .0001) were aware of guidelines concerning the use of interpreters. In emergency communications nurse assistants used authorized interpreters to a significantly lesser extent than physicians (p < .0001) and registered nurses (p < .0001). Physicians used authorized interpreters to a significantly higher extent than registered nurses (p 0.006) and non-authorized interpreters to a significantly lesser extent than registered nurses (p 0.013). In planned communications, nurse assistants used authorized interpreters to a significantly lesser extent than physicians (p < .0001) and registered nurses (p < .0001). Nurse assistants rated their ability to communicate with parents through an interpreter to a significantly lesser extent than physicians (p 0.0058) and registered nurses (p 0.0026). No other significant differences were found. Conclusion The results of the study show insufficient awareness of guidelines in all neonatal units in Sweden. Clinical implications might be to provide healthcare professionals with guidelines and training clinical skills in using interpreters and increasing the availability of interpreters by having interpreters employed by the hospital. Electronic supplementary material The online version of this article (10.1186/s12913-019-4428-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Katarina Patriksson
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Arvid Wallgrens Backe, Box 457, S-405 30, Gothenburg, Sweden. .,Division of Paediatrics, NÄL Hospital, S-461 85, Trollhättan, Sweden. .,Norra Älvsborgs Länssjukhus, Lärketorpsvägen, S-46185, Trollhättan, Sweden.
| | - Helena Wigert
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Arvid Wallgrens Backe, Box 457, S-405 30, Gothenburg, Sweden.,Division of Neonatology, Sahlgrenska University Hospital, S-416 85, Gothenburg, Sweden
| | - Marie Berg
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Arvid Wallgrens Backe, Box 457, S-405 30, Gothenburg, Sweden
| | - Stefan Nilsson
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Arvid Wallgrens Backe, Box 457, S-405 30, Gothenburg, Sweden
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